Sr. Healthcare Informatics Analyst (Medicare Advantage)

Job Title: Sr. Healthcare Informatics Analyst (Medicare Advantage)
Location: 100% Remote (candidate must reside in an approved state: AL, AR, DE, FL, GA, ID, IN, IA, KS, KY, MS, MO, NH, NE, NC, OK, SC, SD, TN, TX, UT, VA, WV, WI)

Company Overview
Glint Tech Solutions is a women-owned, global IT staffing and recruiting firm serving enterprise clients across the USA and Canada.

Project Description
A leading healthcare payer client is seeking a Senior Healthcare Informatics Analyst who will independently provide analytics to understand and improve how healthcare is valued, utilized, and provided. This role develops analytic attributes related to patient-level health utilization/outcomes, provider performance measures, risk-adjusted revenue optimization, medical cost management, and patient/provider engagement behavior, collaborating with business areas and IT to lead problem solving, solution development, and strategic planning.

Key Responsibilities

• Independently provide analytics to understand and improve how healthcare is valued, utilized, and provided
• Develop analytic attributes pertaining to patient-level health utilization/outcomes, provider performance measures, and risk-adjusted revenue optimization
• Support medical cost management and analysis of patient/provider engagement behavior attributes
• Lead problem solving, solution development, and strategic planning in collaboration with other business areas and IT
• Ensure compliance with all laws and regulations associated with duties and responsibilities

Mandatory Skills

• Healthcare experience required, with Medicare Advantage trend analysis experience
• Bachelor's degree in healthcare administration, statistics, economics, analytics, or computer science (4 years of relevant experience may substitute; Master's preferred)
• 4+ years of healthcare, analytics, IT, or management consulting experience
• Strong critical thinking, analytical, and problem-solving skills
• Experience building predictive models
• Strong knowledge of SQL, SAS, R, Python, Tableau, or similar query/analytic/visualization tools
• Basic knowledge of the U.S. healthcare delivery system in a payer or provider setting

Nice-to-Have Skills

• Strong knowledge of outcome research design and controlled study design
• Advanced knowledge of SAS, including Enterprise Miner
• Strong understanding of provider payment methodologies, population health management, and risk adjustment
• Strong understanding of clinical groupers, including episode and risk groupers (DRG, APC, ETG, MEG, DxCG, HCC)
• Strong understanding of quality metrics (HEDIS, AHRQ)
• Knowledge of commercial risk optimization and MA risk optimization